精索内动静脉同时结扎对睾丸血流动力学、生精功能及体积的影响

The effects of artery combing vein ligation within the spermatic cord on blood flow dynamics of testicular,sperm production function and the volume of testicle

目的探究精索内动静脉同时结扎对睾丸动力学、生精功能及睾丸体积的影响。方法随机选取我院于2012年1月至2015年1月收治的精索静脉曲张患者80例为研究对象,并将其随机分为实验组40例和对照组40例,其中对照组患者采用精索静脉高位结扎术,实验组采用精索内动静脉同时结扎术,比较两组患者手术前后睾丸体积、血流动力参数以及精液质量的变化。结果两组患者睾丸动脉血流动力参数最大血流速度(Vmax)、最小血流速度(Vmin)、平均血流速度(Vmean)、搏动指数(PI)及阻力指数(RI)指标手术前后的差异并无统计学意义(P>0.05),两组间比较差异也无统计学意义(P>0.05);实验组患者的精子密度、精子活力、精子存活率等指标术后较术前有改善,差异具统计学意义(P<0.05),但与对照组患者对比差异无统计学意义(P>0.05);两组患者在手术前后的睾丸体积变化对比差异无统计学意义(P>0.05)。结论精索内动静脉同时结扎对精索静脉曲张患者的睾丸血流动力学、生精功能及睾丸体积等无不利影响,并且在改善精液质量方面有一定效果。

Objective To investigate The effects of artery combing vein ligation within the spermatic cord on blood flow dynamics of testicular, sperm production function and the volume of testicle. Methods Total of 80 patients with varicocele were randomly selected as the research object in the study from January 2012 to January 2015. All the patients were randomly divided into the experimental group （40 cases） and the control group （40 cases）. The patients in the control group received ligation of spermatic vein high, and the patients in the experiment received artery combing vein ligation within the spermatic cord. Preoperative and postoperative testicular hemodynamic parameters and the changes of testicular volume, and check the semen quality were comparatively analyzed. Results There were no significant differences in testicular artery hemodynamic parameters, Vmax and Vmin and Vmean, PI and RI indexes before and after surgery for the patients in two groups （P〉0.05）, moreover no significant differences between the two groups （P〉0.05）;No significant differences in live sperm density, sperm vitality, sperm rate indicators were found in the experiment group compared with the control group （P〉0.05）. The change of testicular volume change before and after the surgery was not significant for patients in two groups （P〉0.05）. Conclusion Artery combing vein ligation within the spermatic cord for the treatment of varicocele patients had no adverse effects on testicular blood flow dynamics, sperm production function and testicular volume, which is worthy of clinical popularization and application.